Mr. Shapp also emphasized the
housing needs of older people noting
that nearly three million older people
in 1960 were living in dilapidated, de-
teriorating housing, hazardous to health
and contributing to social breakdown.
Nearly four and a half million dwelling
units are needed to overcome the
acute shortage of appropriate housing
for the elderly.
THE HEALTH BULLETIN
The perplexing cycle of drug addic-
tion, treatment, and relapse may be
partially explained by physical changes
in the body which compel addicts to
resume their habit up to eight months
New findings reported at the Nation-
al Institute of Mental Health Addiction
Reserach Center in Lexington, Kentucky
show that morphine withdrawal causes
two distinct phases of physiological
changes in the body which may also
The physical effects of withdrawal
were previously known to last only
three or four weeks, but a series of
studies in both rats and men indicates
that the "withdrawal syndrome" may
persist for up to 30 weeks.
These findings may partially explain
why 90 percent of the addicts who
relapse do so within six months after
treatment. Relapse of addicts is a seri-
ous problem since some studies show
that 80 to 90 percent of the treated
addicts eventually return to the habit.
The new findings show that patients
have lower than normal blood pressure,
slow pulse rate, and low body tempera-
ture after about nine weeks of absti-
nence, which is the opposite of early
effects of withdrawal. These symptoms,
as well as a marked decrease in the
respiratory center's sensitivity to car-
bon dioxide, last up to 30 weeks.
Immediate withdrawal of morphine
produces severe physical reactions,
although gradual reduction of the drug
and the use of medications can make
withdrawal easier for the patients. How-
ever, high blood pressure, rapid pulse
rate, and high body temperature usual-
ly persist for three or four weeks.
Another related finding is the discov-
ery of elevated levels of epinephrine
in the urine of test subjects several
months after withdrawal. Epinephrine
is produced by the adrenal gland and
may be liberated in excess quantities
In addition, studies in rats indicate
that the withdrawn subjects have a
greater "appetite" for drugs than non-
addicted subjects for a long period
The investigators. Dr. W. R. Martin
and Dr. D. R. Jasinski, say that the find-
ings suggest that dependence on mor-
phine may cause changes in the central
nervous system that last for several
months and produce altered physiologi-
cal functions, an altered psyche, and
increased drug-seeking behavior.
Dr. Martin is the chief of the Addic-
tion Research Center and Dr. Jasinski is
chief of the opiate unit at the Center.
THE HEALTH BULLETIN
"Run for your lifeâ€” or jogâ€” or walk-
but don't just sit there!"
One hears this advice increasingly
these days, and therefore the U.S.
|\m^ Public Health Service's National Center
for Chronic Disease Control is engaged
in examining what occurs if you follow
those simple suggestions.
rQi* In support of the hypothesis that
some form of habitual physical activity
helps reduce the chances of having a
heart attack, the National Center's Heart
^^ f\mnm Disease Control Program is coordinat-
ing Center-sponsored physical exercise
research programs, including projects
at three State universitiesâ€” Minnesota,
I lÂ£^ Wisconsin, and Penn State.
At each of the universities exercise
programs consist of walking, jogging
or running, and calisthenics or modified
game activities. All activities are sup-
ervised by trained personnel. Participa-
tion is on the basis of 45 minutes each
day, three days a week. At Minnesota,
I men were selected at random from two
â– JOQ of the local census tracts. At Wisconsin,
the group consists of middle-aged pro-
fessors, while at Penn State, participants
^^^^__ include a cross-section of male uni-
These projects were designed to an-
Q swer several questions:
D**r â€” What is the most effective way to
identify individuals in the community
who are at greater than average risk
I of developing coronary heart disease?
tJUSi â€” What influences an individual's de-
cision whether or not to participate in
a physical activity program? And if he
decides to participate, what influences
^OH I ^'"^ ^Â° continue to participate on a reg-
ular basis over a long period of time?
â€” What problems are involved in or-
ganizing and administering group phy-
sical activity programs?
â€” What effects does participation in
physical activity programs have on a
person's health in terms of reducing his
February, 1968 THE HEALTH BULLETIN 11
risk of developing a heart attack and
in changing his health attitudes and
A long range goal of the overall re-
search effort is the eventual develop-
ment of coordinated physical activity
progranns in the nation's communities if
future research demonstrates that in-
creased physical activity reduces the
number and severity of heart attacks.
The projects, now entering their
second year of operation, are providing
university scientists and Heart Disease
Control Program specialists the oppor-
tunity to study the effects of various
types of physical activity upon selected
groups of individuals. Participating
at- the three universities are approxi-
mately 450 men between the ages of
40 and 59. As a group, all of these
men were characterized by certain con-
ditions or living habits that increased
their chances of a heart attack. These
â€” High blood pressure
â€” High cholesterol content in the
â€” Cigarette smoking
â€” Lack of major habitual physical
In the studies, participants are di-
vided about equally into two groups;
one that exercises and one that does
not. Periodically both groups are ex-
amined to determine what changes, if
any, have occurred in their health sta-
tus attitudes and habits.
Preliminary findings to date are en-
couraging. All three schools point to
improvements in the general health of
the exercise participants. At the Uni-
versity of Minnesota where the project
has been in operation the longest, there
has been among other things, consider-
able improvement in "heart rate re-
sponse"â€” the ability of the heart to
withstand increasing amounts of phy-
sical exertion at lower pulse rates. As
one participant put itâ€” "we aren't huff-
ing and puffing as much as we used
Perhaps the most significant finding
to date, however, is the conclusion that
individuals can be encouraged to ex-
ercise on a regular basis over a con-
tinuing period of time, provided:
â€” They are properly oriented to op-
portunities for exercise and the pos-
sible health benefits to be derived.
â€” The type of exercise to be per-
formed is determined, at least partial-
ly, by individual preferences.
Of major concern at this time is the
question of whether the present ex-
ercise programs are sufficient to reduce
the participants' risk of developing
heart disease. Project directors also
hope to find ways of motivating in-
dividuals to continue some appropriate
type of exercise after they leave or-
Dr. Bruno Baike, director of the Uni-
versity of Wisconsin project, believes
the latter point may resolve itself, ex-
"Many participants already are or-
ganizing their own exercise groups
against the day when our project ends."
Dr. BaIke, along with project direc-
tors at the other two universities. Dr.
Henry L. Taylor, Minnesota, and Dr.
Elsworth Buskirk, Pennsylvania State
University, is convinced that data pro-
vided by the present series of projects
will become foundation blocks in the
long range efforts, not only to prevent
heart attacks, but also to help victims
of heart attacks to recover from them.
The doctor should be called immedi-
ately when a stroke occurs so that he '
can determine the proper individualized '
treatment for each patient, the North
Carolina Heart Association advises.
THE HEALTH BULLETIN
EASTER SEAL HOME SAFETY CAMPAIGN
1 . He's fascinated by fire, a major
cause of home iniuries. The Easter
Seal Home Safety Checklist shows how
to make your home o safer place to live.
2. She's heading for a fall, the cause
of nearly 12,000 deaths last year and
a major contributor to the nearly Ao
million disabling injuries. Get a copy
of the Easter Seal Home Safety Checklist.
3. The medicine chest is a source of
danger for younger children. The Easter
Seal Home Safety Checklist will tell
you how to protect your children from
poisoning end other home threats.
THE NATIONAL SOCIETY FOR CRIPPLED CHILDREN AND ADULTS
2023 W. Ogden Avenue Chicago, I Mlnois 6061 2
THE HEALTH BULLETIN
The American Cancer Society has
awarded its 1967 Distinguished Serv-
ice Award to Charlotte businessman and
former Senator from Mecklenburg Coun-
ty, Irwin Belk. The award is the highest
honor in the Society.
Belk is the immediate past president
of the North Carolina Division, Ameri-
can Cancer Society, and has done volun-
teer work for the organization on both
the local and state levels. At present he
serves as Chairman of the Nominating
Committee as well as a member of the
Division Executive Committee. He also
serves as Chairman of the Committee
to Study the Utilization of Local Facil-
ities for the Improvement of Patient
Care for the Governor's Cancer Com-
President of Belk Enterprises, Mr.
Belk is the ninth person to receive this
award. Other recipients are Dr. Ivan
Proctor, Raleigh; Judge John D. Larkins,
Jr., Trenton; Dr. H. Fleming Fuller, Kin-
ston; Dr. Donald B. Koonce, Wilming-
ton; Dr. H. Max Schiebel, Durham; Dr.
John R. Kernodle, Burlington; Dr. Paul
Kimmelsteil, Milwaukee, Wisconsin; and
Mr. John R. Jordan, Jr., Raleigh.
In recent years, population studies
have developed a "coronary risk pro-
file " for high-risk America, the North
Carolina Heart Association reports.
With its assistance, physicians can readi-
ly identify "coronary-prone" individuals
years before open symptoms appear-
and can suggest changes in their way
of life or other measures to help ward
off the potential heart attack or stroke.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
James S. Raper, M.D., President Asheville
Lenox D. Baker, M.D., Vice-President Durham
Ben W. Dawsey, D.V.M. Gastonia
Ernest A. Randleman, Jr., B.S.Ph. Mount Airy
Paul F. Maness, M.D. Burlington
A. P. Cline, Sr., D.D.S. Canton
Joseph S. Hiatt, Jr., M.D. Southern Pines
J. M. Lackey Rt. 2, Hiddenite
Howard Paul Steiger, M.D. Charlotte
Jacob Koomen, M.D., M.P.H. State Health Director
W. Burns Jones, M.D., M.P.H. Assistant State Health Director
J. M. Jarrett, B.S. Director, Sanitary Engineering Division
Martin P. Hines, D.V.M. , ALP.H. Director, Epidemiology Division
J. W. R. Norton, M.D., M.P.H. Director, Local Health Division
E. A. Pearson, Jr., D.D.S., M.P.H. Director, Dental Health Division
Lynn G. Maddry, Ph.D., M.S.P.H. Director, Laboratory Division
Ben Eaton, Jr., A. 3., LL.B. . Director, Adtninistrative Services Division
Theodore D. Scurletis, M.D. 1. Director, Personal Health Division
THE HEALTH BULLETIN
The American Heart Association, in
order to provide reassurance to the
public and counteract any anxieties that
heart transplant surgery might be pre-
mature, called a conference early this
year in New York City to clarify its
position on the advisability of this ne\N
The panel discussing the question of
heart transplants was composed of Dr.
Jesse E. Edwards, President of the
American Heart Association and Clini-
cal Professor of Pathology at the Uni-
versity of Minnesota School of Medi-
Dr. Michael E. DeBakey, head of the
world's largest cardiovascular center at
Baylor University College of Medicine,
Houston, and renowned for his accom-
plishments in the development of
mechanical boosting pumps to help
faltering hearts; Dr. John P. Merrill,
Director of the Cardio-renal Section,
Peter Bent Brigham Hospital, Boston,
and leading authority on kidney trans-
Dr. John H. Gibson, Jr., one of the
developers of the heart-lung machine
which has made possible open-heart
surgery and, ultimately, heart trans-
plants; Dr. William L. Glenn, Professor
of Surgery at Yale University School of
Medicine, developer of surgical pro-
cedures to relieve congenital defects,
and a pioneer in pacemaker develop-
ment; Dr. Earl B. Mahoney, Chairman
of the American Heart Association's
Council on Cardiovascular Surgery and
a Professor in the Department of Sur-
gery at Strong Memorial Hospital,
Rochester, N. Y.; and Dr. Lewis E. Jan-
uary, Immediate Past President of Amer-
ican Heart Association, and Professor
of Medicine at the State University of
Iowa College of Medicine.
The 17th Southern Water Resources
and Pollution Control Conference will
be held April 16-18, 1968, at the Uni-
versity of North Carolina, Chapel Hill,
North Carolina. This annual Conference
is co-sponsored by the Department of
Environmental Sciences and Engineering
at the University of North Carolina, and
Departments of Civil Engineering at
North Carolina University and Duke
University. The 17th Conference will
feature presentations and discussions
on the technology of water resources
and water quality management with
particular reference to the southeastern
United States. A detailed program will
be available about January 1, 1968. For
additional information, please write to
Dr. Charles M. Weiss, Chairman Operat-
ing Committee, 17th SWRPC Confer-
ence, Department of Environmental
Sciences and Engineering, P. O. Box
630, Chapel Hill, North Carolina 27514.
Rachel D. Davis, M.D., prominent
Kinston physician and outstanding civic
and educational leader, was elected
President of the North Carolina Divi-
sion, American Cancer Society. She
succeeds Senator Irwin Belk of Char-
lotte in this post.
Deaths caused by high blood pres-
sure have dropped 52 per cent in the
past 20 years for Tarheel men between
the ages of 45 and 64. The North Car-
olina Heart Association says that ad-
vances in the treatment of high blood
pressure, made possible by Heart As-
sociation-supported scientific research,
is a major factor in this saving of lives.
THE HEALTH BULLETIN
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
DIVISION OF HEALTH AFFAIR:. LIEaA
N.C* ME:!4. H03P. U* N- C.
CHAPEL HILL, N.C.
If you do NOT wish to con-
tinue receiving The Health Bul-
letin, please check here i i
and return this page to
the address above.
Printed by The Graphic Press, Inc., Raleigh, N. C
Dates & Events
April 21-22 â€” Annual Meeting, N. C.
Conference for Social Service, Sir Wal-
ter Hotel, Raleigh
April 30-May 1 â€” Tuberculosis Associ-
ation Annual Meeting, Heart of Char-
lotte Motel, Charlotte, N. C.
May 9-10 - Western Branch, N. C.
Public Health Association, High
Hannpton Inn, Cashiers, N. C.
May 13-17 â€” Biennnial Conven-
tion: Annerican Nurses' Association,
May 15-17 â€” Meeting: 38th Annual
Statewide Industrial Safety Confer-
ence, Jack Tar Hotel, Durham
May 16 â€” N. C. Association of Indus-
trial Nurses, Durham
May 19-22 â€” Annual Meeting: Nation-
al Tuberculosis Association, Houston,
May 27-31 â€” Annual Meeting: South-
ern Branch, APHA, Roanoke, Va.
Fourteen migrant health projects, lo-
cated in four states, have recently been
av^arded Public Health Service grants
totalling $1,797,812, Surgeon General
William H. Stewart announced.
The grants, authorized by the Migrant
Health Act, will be used to improve
health services to migrant agricultural
workers and their families. Projects will
use these funds to provide family
health service clinics, medical and
dental care, nursing and sanitation serv-
ices, health education, and in-hospital
Florida, a home-base area for many
migrants, received the largest number
of dollars, $908,588. Projects in Texas,
another home area, were awarded
$715,742. Colorado received $149,339;
One hundred and fifteen projects in
36 states and Puerto Rico are now
receiving Public Health Service support.
Grants are made to State or local pub-
lic agencies and to non-profit private
organizations, which are required to
contribute part of the cost of the proj-
THE HEALTH BULLETIN
JUN 15 1968
:alth affairs library
Carolina State Board of Health
1968 Distinguished Service Award
Eugene Benson Crawford and Elisha Merriman Herndon, senior vice presidents of
North Carolina Blue Cross and Blue Shield, Inc., will receive the 1968 Distinguished
Service Award of the North Carolina Hospital Association.
Selection of Mr. Crawford and Mr. Herndon to receive the award, which is given
annually to an individual who has rendered outstanding service to the hospitals
of North Carolina, was made by the NCHA Trustees.
The two veteran Blue Cross leaders, who have given outstanding encouragement
to the concept of prepaid voluntary health care since the movement began in North
Carolina in 1933, will receive their awards jointly at the annual meeting of the
Hospital Association on June 25 at Wrightsville Beach.
Eugene Benson Crawford
Elisha Merriman Herndon
ARTHUR C. STERN APPOINTED TO
UNIVERSITY OF NORTH CAROLINA
Arthur C. Stern, presently Assistant
Director of the National Center for
Air Pollution Control, Washington, D. C.
has accepted an appointment as Pro-
fessor in the Department of Environ-
mental Sciences and Engineering of the
University of North Carolina School of
Public Health. His appointment in the
Air and Industrial Hygiene program of
the Department v^as facilitated by the
Institute for Environmental Health Stu-
dies at the University.
For all of his professional life. Stern
has been in the air and industrial hy-
giene field. He was for thirteen years
Chief of the Engineering Unit of the
Division of Industrial Hygiene in New
York State and for seven years was
Chief of the Laboratories of Engineering
and Physical Sciences of the Division of
Air Pollution of the Public Health Serv-
ice at the Robert A. Taft Sanitary Eng-
ineering Center in Cincinnati. His edu-
cational background includes the AA.E.
degree in 1930 and the M.S. in 1933
from Stevens Institute of Technology.
Stern is listed in Who's Who in Amer-
ica, Who's Who in Engineering, and
American Men of Science. He is also
editor of the three-volume handbook
"Air Pollution," published in its second
edition this year.
Stern in his new faculty position will
provide a very close tie between the
University and the National Center for
Air Pollution Control which is in the
process of moving to the Research
Triangle of North Carolina only a few
miles from the University.
THE HEALTH BULLETIN
Nationwide cervical screening pro-
ects, supported by the Public Health
Service's National Center for Chronic
Disease Control, are responsible for
saving or prolonging the lives of thous-
ands of American women, according
to an analysis of Center reports cover-
ing a five year period starting in 1962.
Dr. William L. Roberson, Medical Of-
ficer responsible for review of the
screening proects, said that over one
million cytology examinations had been
made at various hospitals throughout
the country and that cervical cancer was
found in more than 6,500 women. More
than 4,000 cases of carcinoma in situ
(Cancer is situ means that the malig-
nancy is at "stage zero," and that there
is no invasion of the normal adjacent
tissue. If treated immediately and
properly, such cancers are almost TOO
There are 143 grant-supported pro-
jects in 35 States, the District of Colum-
bia, and Puerto Rico. Effort has been
concentrated on the low socioeconomic
groups because of their risk of cervical
Dr. Roberson pointed out that the
Center's Cancer Control Program also
supports the American Academy of
General Practice in its "Office Detected
Cervical Cancer Program," now embrac-
ing more than 4,000 physicians in 36
States and the District of Columbia.
The Academy Program has been in
effect since 1965 and more than 546,-
000 women have been screened, about
one-third of them for the first time. A
total of 1,059 carcinomas have been
detectedâ€” 865 in situ and 194 invasive,
according to latest available reports.
Cancer Detection in North Carolina
PERSONS EXAMINED IN CANCER DETECTION CENTERS
BY PLACE OF RESIOENCE: NORTH CAROLINA. 196?
(Total persons examined - 9.552)
CANCER DETECTION CENTERS
are located in
El izabeth Ci ty
New I and
North Ui Ikesboro
The Center Program staff assisted in
organizing the State academies for the
study. Dr. Roberson said. The project
calls for Pap examinations (a very
simple cancer test).
All patients with suspicious or posi-
tive results are followed up to insure
that they are disgnosed and treated if
cancer is present. Those treated for
cancer are scheduled for periodic checks
to make sure the therapy is adequate
and that there is no recurrence of
"The Academy Program establishes
the general practitioner's office as an
appropriate facility for carrying out
this cancer detection project," Dr. Rob-
erson said. "It alerts the private phy-
sician to the need for adequate exami-
nation and follow-up. It shows there is
an impressive number of undiagnosed
cases among the female population. Its
continuation and expansion will mean
much to the general good health of our
country," Dr. Roberson stated.
He added that the number of early
cases detected and cured was highly
significant and "supports our conten-
tion that cervical cancer can be con-
trolled if all women will have a pelvic
examination and Pap smear at least
once a year."
Dr. Roberson estimates that about 26
percent of the women over 20 years of
age in the United States were cytolog-
ically examined in 1966, up from 15
percent in 1963 and 10 percent in
1961. In comparison, Dr. Roberson
pointed to British Columbia, a province
of Canada, where the annual exami-
nation rate is about 65 percent.
All screening projects supported by
the NCCD subscribe to certain stand-
ards such as tissue diagnosis, definitive
treatment and adequate follow-up. In
other respects, the projects are con-
trolled and conducted by the institu-
tions receiving the grants.
Indian Plants Studied
in Cancer Drug Search
The Indian government's Central
Drug Research Institute at Lucknow has
renewed its agreement with the Na-
tional Cancer Institute, National Insti-
tutes of Health, to study native Indian
plants as a source of potential anti-
cancer drugs. A U. S. Public Health
Service contract, using blocked dollars
available under Public Law 480, is pro-
viding $136,000 (1,020,400 rupees)
to finance the next 3 years of investi-
Under the program the Indian re-
search center, directed by Dr. M. L.
Dhar, collects indigenous plants and
from them prepares extracts for study
by the National Cancer Institute in
Bethesda, Maryland. Dr. Jonathan L.
Hartwell, project officer for NC! and
head of its Natural Products Section,
has the extracts tested for their ability
to inhibit animal cancers.
THE HEALTH BULLETIN
First Published â€” April 1886
The official publication of the North Caro-
lina State Board of Health, 608 Cooper
Memorial Health Building. 225 North Mc-
Dowell Street, Raleigh, N. C. Published
monthly. Second Class Postage paid at
Raleigh, N. C. Sent free upon request.
Charles M. Cameron, Jr., M D., M.P.H.
John C. Lumsden, B.C.H.E.
Jacob Koomen, Jr., M.D., M.P.H.
John Andrews, B.S.
Glenn A. Flinchum, B.S.